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' WELL SAMPLE FIELD LOG <br /> 3 <br /> Date:-17— ii.3 6o Well No: T1 CJ -S <br /> Job Name: Job o: <br /> Technician: _,,,. r� ,,] Weather: '�a <br />' Well Casing Diameter: 02" ❑4" ❑6" ❑other: <br /> Well Head Protection: ZOK ❑Needs Following Repairs: <br />' DTGW S .F`�TotaI Well Depth t1,3 Free Product}Thickness Well Under Pressure ❑Yes 2 No <br /> Discoloration: ,`,tc rJiF— Odor: VF l��-r�•, Sediments in Well Water ❑Yes No <br /> Well Purge Equipment:jZ t,'V(— Q��r_� Purge Volume (gal): <br /> Purge Water Disposition �5��:.:a ; '�R4,�, Well Dewatered ❑Yes ❑/ No <br /> 1 <br />' Time Volume al Tem °C Cond. slcm H ORP my <br /> Illi p 7 <br /> ( 313 47 <br /> 1 Water Sample Equipment: 3-1wci � Sample Time: <br /> 7.. <br />' Sample Containers: ❑1 Liter Amber Placed on Ice. ❑Yes ❑No <br /> 2250 ml Chain of Custody: ❑Yes [-]No <br />' ❑Unpreserved VOA's Laboratory: ❑KI FF [Z TEG <br /> Preserved VOA's ❑Other: <br />' ❑ Plastic <br /> Comments: <br /> 1 / <br /> 7 <br /> • Technician Signature: <br /> t <br /> Rev: 318100 TM <br />